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Unformatted text preview: Tumours of the Jaws
Tumours Malignant Tumors
– Is a mass of cells, tissues or organs resembling those normally present but arranged atypically and behave abnormally. Behavior is very essential and is of great importance. Malignant Tumors
origin – Histological:
poorly differentiated Malignant Tumors
– Clinical behavior:
– slowly growing and expanding causing pressure atrophy
but remain within the capsule.
– Very few mitosis could be seen.
– Invade surrounding tissues and locally invasive.
– Progressive growth and metastasize to distant organs,
embolic spread due to lack of cell adhesion
– Mitosis. Intermediate:
– Locally invasive, no metastasis. Basal cell carcinoma
and Malignant Tumors
Oral lesion are:
– Squamous cell
90% Secreting epithelial
5% – Sarcomas:
Others Malignant Tumors
Early diagnosis is very essential for management
Clinical diagnosis from the signs and symptoms Referral for essential investigation Malignant Tumors
CLINICAL DIAGNOSIS OF ORAL CANCER
– Symptoms vary according to the site of the lesion
painless in the early stages
painful and tender when secondarily infected or involves
a sensory nerve
painless lump or ulcer on the lip
Posteriorly no symptom until it reach a size of 2‑3 cm
– pain and difficulty in deglutition absence of symptoms until the tumor metastasize to
regional lymph nodes
– hard lump on the neck
hard Malignant Tumors
ate – pain due to secondary infection or nerve
– excessive salivation
– difficulty in deglutition, speech
– haemorrhage Within bone: – painless swelling involving the buccal and lingual or
– teeth become loose and painful ‑acute alveolar
– edentulous pt. the denture does not fit
– denture hyperplasia
– anaesthesia of the upper or lower lip and the cheek. Malignant Tumors
Carcinoma of lip:
age 50‑70 years. Male
lower – Predisposition factor:
dirty, jagged and stained
iintense solar radiation ‑
blistering cheilitis due to
sunshine. Lower lip affected in
Upper lip affected in 5%
Angle of mouth affected
Metastases within a
year ‑ submental,
– Molluscum pseudo
carcinomatosurn lower lip.
Death due to infection and
bronchopneumonia. Malignant Tumors
Carcinoma of tongue
Anterior 2/3, affect males
Posterior 1/3 equal in both sexes.
Age over 60 years. – Predisposing factors:
Female with cancer tongue suffer from Paterson‑Kelly
Bad oral hygiene
Heavy alcoholic with element of Vit.B deficiency. Producing
precancerous mucosal atrophy
Syphilitic and leukoplakia. 25% and 5%.
Superficial glossitis, papilloma, fissures and non‑specific
ulcers. Malignant Tumors
Site & Types:
– 1. lateral edge of tongue 58%
2. tip of tongue
3. dorsum. of tongue
4. posterior 1/3
2. fissured malignant
4. flat nodules
5. scirrhous or atrophic type Malignant Tumors
– Painless swelling
– Painful infected ulcer, referred pain to the
– Excessive salivation, marked factor oris,
– lloss of mobility due to fixation to the floor
of the mouth. Malignant Tumors
– Fixation occur at first on one side, when tongue is
protruded it deviate toward the affected side
– iindurations, fungation or ulceration which spread
to the floor of the mouth and alveolar process
and from post. 1/3 to the fauces, valleculae and
– Spread to regional lymph nodes.
– Death: Inhalation bronchopneumonia,
haemorrhage, cachexia and starvation and
asphyxia. Malignant Tumors
Carcinoma of the mouth:
– Floor of the mouth.
Typical malignant ulcer extend to alveolar process
tongue. – The cheek:
warty and proliferative. – The alveolar process:
warty, nodules or proliferative. Malignant Tumors
spread extensively before involving bone papillary
or – Soft palate and fauces:
Poor prognosis. bilateral Lymph node involvement
Proliferative, fungating lesion spread to base of
Pain, dysphagia and death due to erosion of
carotid Malignant Tumors
Malignant neoplasm of antrum:
– Squamous cell carcinoma 93% of cases.
– Infiltrate soft tissue, destroys bone, fungate
either through cheek, mouth or pharynx.
– Spread to deep upper cervical lymph nodes.
sarcoma Malignant Tumors
– earliest symptom:
unilateral sera‑sanguineous discharge or frank
epistaxsis in elderly.
unilateral swelling of cheek, buccal sulcus or
dislodging denture, loose Painful and periostitic
teeth &alveolar abscesses
Denture hyperplasia or granuloma.
Denture Malignant Tumors
Anaesthesia of cheek due to involvement of
infra orbital nerve.
Anaesthesia and/or paraesthesia of the palate
due to involvement of sphenopalatine
ganglion Malignant Tumors
– Medial spread:
occlusion of nasolacrimal duct (epiphora)
blocked nostril and blood‑stained discharge of pus – Superior spread:
Eye is proptosed and with involvement of Ms & Ns
strabismus, limitation of movement, diplopia
strabismus, – Trismus due to involvement of medial pterygoid
– Pain due to secondary infection. ...
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- Winter '09